Tusiime Marcia, Musoke David, Muneza Fiston, Mutto Milton, Kobusingye Olive
Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
Chronic Trauma, Injury and Disability Program (TRIAD), School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
Inj Epidemiol. 2022 Jun 10;9(1):18. doi: 10.1186/s40621-022-00382-w.
Globally, burn related deaths are disproportionately higher among children below 5 years of age compared to other age groups. Although rarely fatal, most burns in this group occur within homes specifically in kitchens. This study assessed the prevalence, risk factors and perceptions of caregivers regarding burns among children under 5 years in an urban slum in Kampala, Uganda.
The study used an analytic cross-sectional design with quantitative and qualitative techniques. Quantitative data were collected using a structured questionnaire and observational checklist, while qualitative data involved use of a key informant interview guide. A total of 426 children were involved in the study, while 6 key informants namely an adult mother, teenage mother, community health worker, health practitioner, father and local leader were interviewed. A modified Poisson regression model was used to determine the correlates of burn injuries, prevalence rate ratios and 95% confidence intervals, while thematic analysis was used for qualitative data.
The prevalence of burns among under-fives was 32%, highest among those aged 24 to 35 months (39%), and least in those below 12 months (10%). Children with single parents (adj PR = 1.56 95% CI 1.07-2.29) and those from households in the middle and least poor wealth quintile (adj.PR = 1.72; 95% CI 1.02-2.89 and adj.PR = 1.77; 95% CI 1.02-3.05, respectively) were more likely to get burns compared to their counterparts in other quintiles. In households where flammables were safely stored, children were less likely to suffer from burn injuries (adj.PR = 0.61; 95% CI 0.44-0.83). Congestion, negligence of caregivers, and use of charcoal stoves/open cooking were the commonest determinants of burns. Although many caregivers offered first aid to burn patients, inadequate knowledge of proper care was noted. Crawling children were perceived as being at highest risk of burns.
The prevalence of burns among children under 5 years was high, with several household hazards identified. Health education, household modification and applicable public health law enforcement are recommended to reduce hazards and minimise burn risks among children.
在全球范围内，与烧伤相关的死亡在5岁以下儿童中比其他年龄组更为普遍。虽然这类烧伤很少致命，但该年龄组的大多数烧伤发生在家里，特别是在厨房。本研究评估了乌干达坎帕拉一个城市贫民窟中5岁以下儿童烧伤的患病率、危险因素以及照顾者的看法。
本研究采用分析性横断面设计，结合定量和定性技术。定量数据通过结构化问卷和观察清单收集，而定性数据则通过关键信息访谈指南收集。共有426名儿童参与了该研究，同时采访了6名关键信息提供者，即成年母亲、青少年母亲、社区卫生工作者、医生、父亲和当地领导人。采用修正的泊松回归模型来确定烧伤的相关因素、患病率比值和95%置信区间，而定性数据则采用主题分析。
5岁以下儿童的烧伤患病率为32%，在24至35个月大的儿童中最高（39%），在12个月以下的儿童中最低（10%）。单亲家庭的儿童（调整后的患病率比值=1.56，95%置信区间为1.07-2.29）以及来自中等贫困和最贫困财富五分位数家庭的儿童（调整后的患病率比值分别为1.72；95%置信区间为1.02-2.89和调整后的患病率比值为1.77；95%置信区间为1.02-3.05）比其他五分位数家庭的儿童更容易烧伤。在易燃物品安全存放的家庭中，儿童烧伤的可能性较小（调整后的患病率比值=0.61；95%置信区间为0.44-0.83）。拥挤、照顾者疏忽以及使用木炭炉/露天烹饪是烧伤最常见的决定因素。虽然许多照顾者对烧伤患者进行了急救，但对正确护理的知识不足。学步儿童被认为烧伤风险最高。
5岁以下儿童的烧伤患病率很高，发现了几个家庭危险因素。建议进行健康教育、家庭改造和适用的公共卫生执法，以减少危险因素并将儿童烧伤风险降至最低。
